Fillable Witness statement template (Cabinet Office)

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Witness statement template (Cabinet Office)

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The Witness statement template (Cabinet Office) form is 16 pages long and contains:

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Country of origin: UK
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1
Please complete this statement to the best of
your ability.
The information that you supply will assist the Judge
in having an understanding of the background to the
current case and will assist the Judge in coming to a
decision. If any of the questions are not relevant to
your case or if you are unable to answer any particular
question please say so on the form.
Each parent’s responses to this statement will be
disclosed to the other parent or party.
Witness statement template
Child arrangements - Parental dispute
The family court sitting at
Case number
Name of applicant
Name of respondent
The name of the parent, or other party, completing this form:
Please give the full names and dates of birth for each child and indicate with whom they live
Child’s full name Date of birth With whom the child lives
me other parent
other person
me other parent
other person
me other parent
other person
me other parent
other person
me other parent
other person
C120 Witness statement template - Child arrangements - Parental dispute (11.14) © Crown copyright 2014
1. Do any of the children have any medical problems? Yes No
If Yes, please give details
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2
2. Did you and the other parent (or other party) live together? Yes No
If Yes, please give the
approximate date when you started to live together
date of separation
3. Please give brief details of the circumstances of the separation
4. Please describe the childcare arrangements in place between you and the other parent or party before the
proceedings were issued? When and how often did the other parent or party spend time with the child?
3
5. Please give a brief description of the child(ren)’s routine during the week and at weekends. Please also
advise how each parent or other party has been involved with such routines. Also give details of other family
members who help or are available to help.
6. If you are in work, what are your working hours? If a child lives with you, who looks after the child when
you are at work?
4
8. How far away do you live from the other parent or party?
9. How long does the journey take by public transport or car?
10. Please state how far away the child(ren)’s school is from your home and
how the child(ren) get to and from school.
7. Please describe the homes in which the child lives, stays or spends time. State whether it is a at, maisonette or a
house; wits size (i.e. how many bedrooms?) and the sleeping arrangements for the child (if they currently stay)?
5
11. Please describe the child(ren)’s out of school activities, their hobbies and pastimes.
12. Please describe each child’s personality, likes and dislikes and any particular needs they may have.
6
14.
Please give y
our view as to the quality of children’s past and current relationship with the other parent or party.
Do you think that this needs to be improved, and if so, how can the court help you as parents to do that?
13. Are there any concerns or issues about the child(ren)’s schooling? Yes No
If Yes please give details.
7
15. Please describe how the child(ren) are coping with the separation of their parents and the current issues
between you and the other parent or party.
16. What childcare and parenting arrangements are you asking the court to implement. Who do you say the
child/children should live with? How much time should the child/children spend with the other parent or
party or anyone else? Please give your reasons for the arrangements you want.
8
17. Do you have any worries about the other parent’s parenting abilities? Yes No
If Yes, what are they?
18. Have you or the children ever been involved with
social services or the police?
Yes No
If Yes, when?
Do you know which Local Authority was involved or have any contact details?
Please give brief details of why and what happened?
9
19. What steps have you taken to reach agreement with the other parent or party about the arrangements
for the children? What is preventing you being able to reach an agreement with the other parent or party
in respect of the arrangements for the children? (do not include here the content of discussions held in
mediation sessions)
20. What do you feel you can do to help the court in making a parenting order that will satisfy both parents
(or other party) and the children’s welfare?
10
21. Please give the Court details of any other information that you consider relevant to the case.
Statement of truth
I believe the that the facts stated in response to the above questions are true.
Signed (mother/father)
Dated
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Witness statement template (Cabinet Office)

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Completed 17 July 2021

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